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运动对膝骨关节炎的影响:系统评价。

Effects of exercise on knee osteoarthritis: A systematic review.

机构信息

Health Sciences Department, University of Aveiro (ESSUA), Aveiro, Portugal.

University Hospital of Coimbra, Coimbra, Portugal.

出版信息

Musculoskeletal Care. 2021 Dec;19(4):399-435. doi: 10.1002/msc.1538. Epub 2021 Mar 5.

Abstract

BACKGROUND

Knee osteoarthritis is the most common joint disease and a major cause of functional limitation and pain in adults. The aim of this literature review is to review the existing evidence regarding the impact of exercise in people with knee osteoarthritis concerning physical and functional outcomes. The secondary aim is to provide both healthcare professionals and patients with updated and high-quality recommendations for the management of this condition.

METHODS

A systematic search was performed at Pubmed, Scopus and Web of Science databases, limiting the studies to English, French and Portuguese language, from 2010 to May 2020. Eligible studies were randomized control trials or clinical control trials that compared an intervention consisting of an exercise programme in adult participants with knee osteoarthritis against no intervention.

RESULTS

A total of 4499 studies were retrieved and 19 articles met the inclusion criteria. Beneficial effects of exercise were found on pain and strength. Regarding function, functional performance and quality of life, evidence is controversial. Both strengthening and aerobic exercise showed positive effects and both aquatic and land-based programmes presented improvement of pain, physical function and quality of life. Relatively to stretching, plyometric and proprioception training, no concrete conclusions can be taken.

CONCLUSION

Exercise programmes appear to be safe and effective in knee osteoarthritis patients, mainly regarding pain and strength improvement. Pilates, aerobic and strengthening exercise programmes performed for 8-12 weeks, 3-5 sessions per week; each session lasting 1 h appear to be effective. Both aquatic and land-based programmes show comparable and positive effects.

摘要

背景

膝骨关节炎是最常见的关节疾病,也是成年人功能受限和疼痛的主要原因。本文献复习的目的是回顾现有的关于运动对膝骨关节炎患者身体和功能结果影响的证据。次要目的是为医疗保健专业人员和患者提供针对这种情况的最新和高质量的管理建议。

方法

在 Pubmed、Scopus 和 Web of Science 数据库中进行了系统检索,将研究限制在英语、法语和葡萄牙语语言,时间从 2010 年到 2020 年 5 月。符合条件的研究是比较包含运动方案的干预措施与无干预措施的成人膝骨关节炎参与者的随机对照试验或临床对照试验。

结果

共检索到 4499 项研究,19 项符合纳入标准。运动对疼痛和力量有有益的影响。关于功能,功能表现和生活质量的证据存在争议。力量训练和有氧运动都显示出积极的效果,水上和陆上运动方案都改善了疼痛、身体功能和生活质量。至于伸展、弹震和本体感觉训练,不能得出具体的结论。

结论

运动方案似乎对膝骨关节炎患者是安全且有效的,主要是在改善疼痛和力量方面。8-12 周、每周 3-5 次、每次 1 小时的普拉提、有氧运动和力量训练方案似乎是有效的。水上和陆上运动方案都显示出类似的积极效果。

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